Maternal-infant outcomes of birth planning: A review study.

The birth and delivery plan is the center of clinical communication between the pregnant woman and the midwife, which is in the scope of health care services and is designed and provided to specialists with the participation of the woman and her husband during pregnancy. This document reflects the preferences, expectations, and fears of pregnant women regarding the birth process. This study was conducted with the aim of determining the maternal and neonatal outcomes of the birth plan: a review study. In this review study, Persian databases Magiran, SID, and English databases Pubmed, Scopus, SID Elsevier, Web of Sciences, and Google Scholar search engine using English keywords including Maternal outcome, neonatal outcome, birth schedule, delivery plan, birth plan, and their Persian equivalents were searched from 2000 to 2022. Numerous studies were selected and analyzed in a quantitative and qualitative manner that was related to the purpose of the present study in terms of content. Among 948 articles, 13 of the most relevant ones were selected and analyzed for this study. The results of the review of the studies showed that the birth plan has an effect on women's empowerment, satisfaction with childbirth, positive experience of childbirth, cesarean section rate, epidural use rate, episiotomy rate, Apgar, and umbilical cord pH of the newborn. The maternal and neonatal consequences of the birth plan prevail over its negative consequences, and the use of the birth plan can increase women's empowerment, satisfaction with childbirth, positive experience of childbirth, and reduce the rate of cesarean section and negative maternal-neonatal consequences.

Investigating the effect of mindfulness counselling on sexual functioning of women with premenstrual syndrome.

Mindfulness exercises can improve a wide range of the psychological and interpersonal consequences of premenstrual syndrome. Nevertheless, there is sparse information about the effect of mindfulness counselling on sexual dysfunction in women with this condition. This study aimed to determine the effect of mindfulness counselling on the sexual functioning of women with premenstrual syndrome. In this controlled randomized study, 112 women diagnosed with premenstrual syndrome referred to selected urban healthcare centers in Isfahan, Iran, were randomly allocated to two groups (intervention and control), each with 56 participants. The intervention group underwent mindfulness counselling in eight 60-minute sessions online via Google Meet. The control group did not receive any kind of intervention. The principal measure was score on the Rosen Female Sexual Functioning Index (FSFI) before, immediately, and one month after the intervention. The data were analyzed by SPSS 23, through descriptive and analytical statistical tests (chi-square, Mann-Whitney, independent t-test, ANOVA, and repeated measure) with a significance level of 0.05. There was no statistically significant difference in the mean FSFI score (or the subscores) between the intervention and control groups (p greater than 0.05) at baseline. In the intervention group, there were significant increases (relative to both baseline and in comparison with the control group) in the mean subscores for sexual desire (P < 0.0001), orgasm (P = 0.01), satisfaction (P = 0.0001), sexual pain (P = 0.003), and general sexual functioning (P < 0.0001) immediately after and one month after the intervention, but the score for sexual arousal was significantly greater only at the one-month evaluation (P < 0.0001) and there were no differences in the scores for vaginal lubrication. On the other hand. Mindfulness counselling was effective in improving the sexual functioning of women suffering from premenstrual syndrome, and should be used for this purpose in healthcare centers.

Effect of intervention based on the 5A self-management model on the improvement of behaviors related to women's reproductive health after legal abortion.

Legal abortion has adopted many beneficial measures to prevent the birth of fetuses with congenital anomalies and maintain the health of high-risk mothers. However, abortion has its own complications and, thus, most mothers need care in this regard. The aim of this study was to determine the effect of self-management model on behaviors related to the reproductive health of mothers after legal abortion. This clinical trial study was conducted on 72 women who had legal abortion with the permission from Isfahan forensic medicine. The intervention was conducted using the 5A self-management model. The control group received the usual health system cares. Data collection tool was a researcher-made questionnaire of behaviors related to reproductive health, which was completed before and two months after the intervention by the two groups. The total mean score of the behavior (P < 0.001) and its dimensions (Prevention of post-abortion complications with P = 0.01, Prevention of sexually transmitted infections, satisfactory sexual function and family planning with P < 0.001) in the intervention group two months after the outset of the intervention was significantly higher than before the intervention. The total mean score of the behavior (P < 0.001) and its dimensions (Prevention of post-abortion complications with P = 0.002, Prevention of sexually transmitted infections, satisfactory sexual function and family planning with P < 0.001) two months after the outset of the intervention in the intervention group was significantly higher than the control group. Based on the results, this educational model can be emphasized to promote reproductive health behaviors of women after abortion.Clinical trial protocol link: https://www.irct.ir/user/trial/55184/view .

Environmental factors influencing women's childbirth experiences in labor-delivery-recovery-postpartum unit: a qualitative cross-sectional study.

BACKGROUND: Women's experiences of birth environment influence their mental health and that of their families. Identifying women's childbirth experiences in the labor-delivery-recovery-postpartum unit (LDRP) unit can help design a peaceful environment. Therefore, this study aimed to evaluate environmental factors influencing women's childbirth experiences in LDRP unit. METHODS: This qualitative cross-sectional study was conducted on 20 women with a childbirth experience in the LDRP unit. A purposive sampling was performed and continued until data saturation. The data were collected through unstructured interviews and analyzed using inductive content analysis. RESULTS: Data analysis led to the extraction of three categories: physical security, a meaning-oriented environment, and physical comfort. The physical security category was obtained from three sub-categories: privacy, bed ergonomics, and the possibility of medical interventions. The meaning-oriented environment category was extracted from four sub-categories: promising symbols of becoming a mother, a peaceful environment, and a spiritual environment, and the physical comfort category was extracted from three sub-categories: minimizing noise pollution, ambient lighting, and LDRP internal design. CONCLUSIONS: These study results showed that women's experience of giving birth in LDRP was accompanied by perceiving physical security, a meaning-oriented environment, and physical comfort. Moreover, the results indicated that the childbirth experience in the LDRP unit might be influenced by physical and emotional environmental factors. Therefore, in order to design a peaceful environment, it is necessary to take into account these factors.

Improving sexual dysfunction through guided imagery music (GIM): A clinical trial study.

BACKGROUND: Women with perfect health are strong foundations of a healthy and prosperous family life and suppressing the natural needs of women will have adverse effects on the intimacy and vitality of family members, especially in the field of sexual function. This study aimed to determine the effect of GIM on the level of sexual function in women with sexual dysfunction. MATERIALS AND METHODS: In this cluster randomized trial, which was conducted from 2018 to 2019 in the randomly selected comprehensive health centers of Isfahan, Iran, 72 women of reproductive age (two groups of 36 people) with sexual dysfunction were selected by convenience sampling method, and then, music-guided imagination was performed on the intervention group. No special intervention was performed in the control group. Data collection tools were demographic characteristics questionnaire and a standard questionnaire of the female sexual function index. RESULTS: There was no statistically significant difference in sexual function and demographic characteristics before the intervention between the two groups (P = 0/301). The results demonstrated that the overall score of sexual function in the intervention subjects was better than the control group (P = 0/003). Improvement of sexual function dimensions (desire, arousal, orgasm) was also significant in the intervention group compared to the control group (P < 0.05). CONCLUSION: GIM can be effective in improving women's sexual function. Providing this technique as a low-cost and affordable method is recommended to health experts in private and government clinics. This method can improve the mental health of the family and society.

The relationship between hope and happiness with prenatal care.

INTRODUCTION: Prenatal care refers to proper and principled implementation aimed at maintaining a healthy pregnancy in terms of physical health and favorable psychological outcomes for the mother, infant, and family. The adequacy of prenatal care is an important indicator in predicting infant and maternal mortality. Mental health components such as hope and happiness can influence the quality of prenatal care. The aim of this study was to determine the relationship between hope and happiness with prenatal care. METHODS: This is a cross-sectional study that was performed on 200 pregnant mothers referred to Isfahan, Iran, comprehensive health centers in 2018 using an available sampling method. The research instrument was a questionnaire of hope, happiness, and quality of prenatal care that was completed by qualified people. The data were analyzed by descriptive and analytical statistical methods (Pearson correlation). RESULTS: The results of this study showed that there is a significant relationship between the adequacy of care and overall hope score (P = 0.032). There was also a positive and significant relationship between the adequacy of care and the subscales of hope (thinking [P = 0.002] and path [P = 0.004]). There was a positive and significant relationship between the adequacy of prenatal care and overall happiness score (P = 0.03). Positive emotion subscale (P = 0.033) had a significant positive correlation and negative emotion subscale (P = 0.001) had a significant negative relationship with the adequacy of prenatal care. CONCLUSION: According to the results, mental health can affect the quality of prenatal care. As a result, health providers to pregnant mothers can improve the adequacy of prenatal care by examining pregnant women in terms of these two issues, thereby improving the health of themselves and their children, and ultimately, community health.

Maternal health improvement through root cause analysis of severe maternal morbidity (maternal near miss) in Isfahan, Iran.

INTRODUCTION: Investigating severe maternal morbidity and near-miss cases are applied internationally as a new indicator to examine the quality of maternal care and as an effective strategy to reduce maternal mortality. This study aimed to determine the root causes of severe maternal morbidity in order to improve maternal health. MATERIALS AND METHODS: The present research is a descriptive case series study. The data was obtained from the hospital and health records of mothers admitted to hospitals affiliated to Isfahan University of Medical Sciences due to severe morbidity in the first 6 months of 2018, which were selected randomly. The data collection was completed by interviews with the mentioned mothers and 14 related health-care staffs and that led to the development of the morbidity story. The compiled story of each case was evaluated by the root analysis team's opinion. Causes of morbidity were determined according to a root cause analysis checklist composing of factors such as health-care services (human and structural factors), family-social status, and disease status of maternal morbidity. RESULTS: The findings indicated that human factors related to the health system led to severe maternal morbidity more than any cause. Inadequate knowledge and skills of service providers, disregard for guidelines and protocols, lack of teamworking, and lack of considering competency were the most important human factors. Disease condition, family, and social status were the other related factors, respectively. CONCLUSION: Human factors are the most important cause of maternal morbidity based on the results of this study. Therefore, modifying the health structure can be one of the most important reducing factors for maternal mortality in order to improve the services for these individuals.

Analysis of the Iranian maternal mortality surveillance system and providing system improvement strategies: study protocol for strategy formulation.

BACKGROUND: The implementation of the maternal mortality surveillance system in Iran has significantly reduced the incidence of maternal mortality. However, the pattern of the causes of the mortalities, which has remained constant over the years, are still concerning. This study aimed to explain the experiences of the actors of the Iranian maternal mortality surveillance and provide strategies for improving this system. METHODS: This research is a qualitative study to develop strategies, that will be conducted in two phases. In the first phase, purposive sampling will be performed, and the data will be collected based on the experiences of the Iranian maternal mortality surveillance system actors in Iran's Ministry of Health and the selected universities (Shiraz, Isfahan, Tehran, Zahedan, Alborz, Shahrekord) through semi-structured interviews. Moreover, during this phase, some part of the data will be collected through random participation of the researcher in some maternal mortality committees of the selected universities. In order to carry out the second phase, a panel of experts will be set up to discuss the best strategies for improving the Iranian maternal mortality surveillance by considering the above results. DISCUSSION: The analysis of maternal mortality surveillance system needs to evaluate the experiences of the actors who are the policymakers of this system and can be effective in identifying its challenges. This analysis and formulation of the subsequent strategies can lead to maternal health indicators remaining within the range of international standards or even beyond those standards in Iranian universities and countries with similar surveillance system.

Improving service delivery using the self-reporting of errors by midwives and midwifery student.

INTRODUCTION: Reporting medical errors is one of the common methods for identifying and preventing mistakes in-hospital care. This study was conducted to identify the status of reporting and related factors in two groups of midwives and midwifery students. METHODOLOGY: This research was analytic correlational; it was conducted among all the midwives working in the midwifery and labor departments and midwifery students in Isfahan University of Medical Sciences. The data collection tool included a checklist of errors and the researcher-construed questionnaires of awareness and attitude toward reporting errors. The results were examined using descriptive and inferential statistics (ANOVA, Pearson and Spearman correlation coefficient, and independent t-test) by SPSS software version 20. RESULTS: In this research, the error reporting in midwifery staff was 79.1% and the most frequent error was related to the patient's process of testing; the error reporting among the students was 90% and the most frequent error occurred in the labor processes. The present study also showed that there was a direct relationship between awareness and attitude toward reporting medical errors (P < 0.001), while there was not a significant relationship between the midwifery students' awareness and attitude toward reporting the medical errors (P = 0.31). CONCLUSION: According to the study, hospital midwives reporting is less than midwifery students. Accordingly, it is recommended to focus on the error and risk management committee to strengthen the reporting system.

Investigating the relationship between cognitive emotion regulation and the health of pregnant women.

INTRODUCTION: Mental health is one of the focuses of the health assessment of different communities and plays an important role in ensuring the dynamism and efficiency of each community. Pregnancy is one of the most sensitive periods, in which mental health is effective. The mental health of individuals is the result of the interaction of cognitive-emotional ordering strategies and proper evaluation of stressful situations. The aim of this study was to determine the relationship between cognitive emotion regulation and the health of pregnant women. MATERIALS AND METHODS: This is a descriptive and cross-sectional study that was carried out on 200 pregnant women who were covered by Navab, Amir Hamzeh and Motahari centers in Isfahan in 2017 by available sampling method. The instrument was the Beck Depression Inventory, Goldenberg Health, and Emotional Cognitive Order. Finally, the data were analyzed using the SPSS software. RESULTS: The mean age of pregnant mothers participating in the study was 26.66 ± 6.09 years. The results of data analysis showed a significant positive correlation in relation to blaming others and disaster with physical health, blaming others and rumination and catastrophes with anxiety, disaster with social health, blaming others and rumination and catastrophes with depression, and also blaming others and rumination, catastrophizing, and positive re-focusing have a significant positive correlation with total health score. CONCLUSION: Regarding the relationship between mental health and cognitive dysmenorrhea during pregnancy, pregnant women carers can help with pregnant women by conducting educational programs on health promotion and strive to maintain mental health and improve their quality of life. Consequently, they will ensure the mental health of their future children.

Investigating the service provision challenges by healthcare providers in selected comprehensive health centers.

INTRODUCTION: The healthcare program has opponents and supporters with its multiple policies and also its difficult implementation, which requires that its barriers and problems be addressed comprehensively and extensively. This study was conducted aimed to determine the service provision challenges by healthcare providers, from their point of view, in selected comprehensive health centers of Isfahan. MATERIALS AND METHODS: The present study is a descriptive-analytic one. One-hundred and ninety-seven healthcare providers were selected by census sampling method from the population of female healthcare providers in Isfahan comprehensive health centers in 2017. The data collection tool was a researcher-made questionnaire in the field of individual-professional, managerial-organizational, and executive challenges. Data analysis was done by repeated measures ANOVA and post hoc test. RESULTS: The findings indicated that there was a significant difference between the mean score of individual-professional, managerial-organizational, and executive challenges (P < 0.001) from the point of view of healthcare providers. According to least significant difference post hoc test, the mean score of individual challenges was significantly lower than that of managerial and executive challenges (P < 0.001). However, there was no significant difference between the mean score of managerial-organizational and executive challenges (P = 0.46). CONCLUSION: Based on the results, healthcare providers have put forward several challenges during the implementation of the healthcare program. Meanwhile, executive and managerial challenges have been considered more than individual challenges. Considering that this could lead to improper service provision to the clients, the role of policymakers in this program to remove obstacles and to provide satisfaction to healthcare providers is emphasized.

Breastfeeding and its outcome in Women Receiving Epidural Analgesia for Childbirth.

BACKGROUND: Breastfeeding is an important issue in postpartum period and critical to the infant's health, but childbirth interventions such as childbirth analgesia may affect the onset and duration of the process. This study aimed to determine the status of breastfeeding in women receiving epidural analgesia. MATERIALS AND METHODS: This cohort study was conducted on 393 mothers in the postpartum period that had vaginal delivery with or without using epidural analgesia (with their own choice) between December 2017 and September 2018. After selecting the convenient samples, the researcher-made outcome breastfeeding checklists were completed in selected hospitals in Isfahan, Iran, Within 24 hours and 4 weeks after delivery. Data were analyzed using statistical methods (Independent t test, Mann-Whitney, ANCOVA, and Chi-square). The significance level of the tests was less than 0.05. RESULTS: According to the results, most of the subjects in the two groups began breastfeeding during the first hour after childbirth. There was no significant difference between the two groups in the beginning of breastfeeding while controlling the number of labors. There was no significant difference between the two groups in comparison to the type of milk given to the infant Within 24 hours after birth and 4 weeks after birth, either. There was no significant difference between the two groups in comparison to breastfeeding problems at either time. CONCLUSIONS: According to the results, saying that there is no negative effect by epidural analgesia on the breastfeeding process, using this analgesia is recommended to promote natural childbirth.

The effect of walking on pregnancy blood pressure disorders in women susceptible to pregnancy hypertension: A randomized clinical trial.

BACKGROUND AND OBJECTIVES: Hypertension in pregnancy is one of the most important unsolved problems in midwifery, and since it is the main cause of maternal death, preventive intervention measures are essential to control this serious complication. This study aimed to determine the effect of walking on gestational hypertension disorders in women prone to hypertension. MATERIALS AND METHODS: This randomized clinical trial was conducted on 72 pregnant women susceptible to gestational hypertension who were randomly (through a random number table) assigned into two groups of 36. The pregnant women in the experimental group had walking program for 20-30 min from weeks 14-34, four times a week. Data were analyzed, via independent t-test, Fisher's exact test, and Chi-square test. RESULTS: The results indicated that in the experimental group, 2 cases with transient gestational hypertension and 1 case of preeclampsia existed, and in the control group, 9 pregnant women were with gestational hypertension and 4 pregnant women were with preeclampsia. Therefore, the incidence of these two complications in the experimental group was significantly lower than the control group (P < 0.05). Moreover, the mean systolic and diastolic blood pressures in the experimental group were significantly lower than the control group (P < 0.05). CONCLUSION: Based on the results, the moderate walking, as an easy physical activity, is recommended for pregnant women susceptible to pregnancy hypertension.

The relationship between perfectionism and body image with eating disorder in pregnancy.

INTRODUCTION: Mental health is very important during pregnancy, and perfectionism, body image, and eating disorder are three important factors in mental health. Given that eating disorders are very dangerous in pregnancy, the aim of this study was to determine the relationship between perfectionism and body image with eating disorder in pregnancy. METHODS: This descriptive study was performed on 200 pregnant women referred to Isfahan Health Centers in 2017. The research units, if met the inclusion criteria, completed the Eating Attitudes Questionnaire, Multidimensional Relationships of their Body Questionnaire, and Perfectionism Questionnaire. Finally, the data were analyzed by SPSS software version 22, with a significance level of 0.05. RESULTS: The results showed that there was a significant negative relationship between positive perfectionism with symptoms of eating disorder, anorexia nervosa, and nervous longing to eat. There was a significant positive correlation between negative perfectionism with symptoms of eating disorder, anorexia nervosa, and nervous longing to eat. The results also showed a significant negative relationship between body image and its dimensions with symptoms of eating disorder, anorexia nervosa, and neurasthenia. CONCLUSION: Perfectionism and body image and its dimensions are psychological problems related to eating disorder in pregnancy. For this reason, it seems that taking classes for pregnant women and their spouses can reduce the incidence of this disorder.

Applicability of the Ben-Tovim Walker Body Attitude Questionnaire in Moslem women.

There are some valuable questionnaires to assess the body attitude but applicability of those in Moslem women is unknown and the aim of this study was assessment of the validity and reliability of the Iranian-translated versions of the Ben-Tovim Walker Body Attitudes Questionnaire (BAQ) in Iranian women. The BAQ 44 item was administered to 304 healthy non-pregnant Iranian women. A confirmatory factor analysis was carried out. The internal consistency reliability and Inter-correlations of the BAQ subscales and concurrent validity were assessed. The results showed that 9 out of 44 items had insignificant regression weights on the respective factors that further were nominated to deletion. The 6-factor model has an acceptable fit with the data. The internal consistency was .91 for all scale of 35-item BAQ. The coefficient of repeatability (ICC) respectively were .78, .77, .89, .94, .86 and .79 for attractiveness, disparagement, feeling fat, salience of weight/shape, lower body fat and strength and fitness. Results showed that the 6-factor model the 35-item questionnaire is appropriate for evaluating body attitude in Moslem women.

Evaluating the Effective Factors for Reporting Medical Errors among Midwives Working at Teaching Hospitals Affiliated to Isfahan University of Medical Sciences.

BACKGROUND: Recently, evaluation and accreditation system of hospitals has had a special emphasis on reporting malpractices and sharing errors or lessons learnt from errors, but still due to lack of promotion of systematic approach for solving problems from the same system, this issue has remained unattended. This study was conducted to determine the effective factors for reporting medical errors among midwives. MATERIALS AND METHODS: This project was a descriptive cross-sectional observational study. Data gathering tools were a standard checklist and two researcher-made questionnaires. Sampling for this study was conducted from all the midwives who worked at teaching hospitals affiliated to Isfahan University of Medical Sciences through census method (convenient) and lasted for 3 months. Data were analyzed using descriptive and inferential statistics through SPSS 16. RESULTS: Results showed that 79.1% of the staff reported errors and the highest rate of errors was in the process of patients' tests. In this study, the mean score of midwives' knowledge about the errors was 79.1 and the mean score of their attitude toward reporting errors was 70.4. There was a direct relation between the score of errors' knowledge and attitude in the midwifery staff and reporting errors. CONCLUSIONS: Based on the results of this study about the appropriate knowledge and attitude of midwifery staff regarding errors and action toward reporting them, it is recommended to strengthen the system when it comes to errors and hospitals risks.

Women Coping Strategies towards Menopause and its Relationship with Sexual Dysfunction.

BACKGROUND: Paying attention to sexual dysfunction and its coping strategies is essential owing to its impact on mental health in postmenopausal women and their families. This study aimed to determine the relationship between women coping strategies toward the process of menopause and sexual dysfunction in menopausal women. MATERIALS AND METHODS: This is a cross-sectional study in which 233 married menopausal women were sampled in the first 5 years after cessation of menstrual cycle using health records in the health centers in Isfahan in 2015. The method of data collection was a demographic characteristics form, sexual function questionnaire of Rosen et al., along with a researcher-made coping strategies questionnaire. The validity and reliability of these instruments were assessed, and the resulting data were analyzed utilizing inferential statistical tests (t-test and Chi-square test) and SPSS 16 software. RESULTS: According to the results of this study, the relative frequency of sexual dysfunction in menopausal women is 67.42%. The mean score of the avoidance strategy in people with overall sexual dysfunction was significantly higher than the group without disorder (P < 0.001). The mean of coping strategies of social support seeking (P < 0.001), problem-solving (P = 0.016), and target replacement strategy (P = 0.004) were significantly lower than that in the group without disorder. CONCLUSIONS: In line with the findings of this study, problem-oriented strategies such as social support, problem solving, and target replacement are the best strategies for decreasing sexual dysfunction or increasing sexual satisfaction. These results emphasize the reinforcement of health personnel skills in teaching approach of these strategies to this group of women.

Evidence-based Draft Guideline for Prevention of Midwifery Malpractices based on Referred Cases to the Forensic Medicine Commission and the Medical Council from 2006-2011.

BACKGROUND: Medical errors are the main concerns in health systems, which considering their ascending rate in the recent years, especially in the field of midwifery, have caused a medical crisis. Considering the importance of evidence-based health services as a way to improve health systems, the aim of this study was to suggest a guideline for preventing malpractice in midwifery services. MATERIALS AND METHODS: In this cross-sectional study that was conducted in 2013, we investigated 206 cases that were referred to the Isfahan Legal Medicine Organization and Medical Council of Forensic Medicine from 2006-2011. Data were collected by a checklist and were analyzed using SPSS-16 software. Descriptive statistical tests (mean, maximum, minimum, standard deviation, frequency, and percentage agreement) were used to describe the data. Then, we used the Delphi technique with the participation from 17 experts in midwifery, gynecology, and legal medicine to provide an evidence-based draft guideline for prevention of midwifery errors. RESULTS: A total of 206 cases were reviewed. In 66 cases (32%) the verdict for malpractice in midwifery services was approved. A practical draft guideline for preventing clinical errors for midwifery in the fields of pregnancy, delivery, and postpartum period was developed. CONCLUSIONS: This evidence-based draft guideline can improve the attention of all the healthcare providers, especially midwives and physicians to prevent urgent problems and offer effective health services for mothers and infants.

Assessment of Barriers for Midwives to Achieve Professional Management Positions from Midwives' Point of View.

BACKGROUND: Despite the effects of midwives on the health of family and community through promotion of maternal and child health indicators, they are not in the position of professional decision making. Therefore, this study was aimed to determine the barriers to achieve professional management positions by midwives. MATERIALS AND METHODS: This study was a descriptive and cross-sectional study. The members of board commission of midwifery and reproductive health, the academic members of midwifery department and midwives working at the adjutancy of health and treatment were selected from eight Iranian universities of medical sciences. Data was collected through demographic characteristics questionnaire, a researcher-made questionnaire about administrative barriers, and management skills. Validity and reliability of this tool was confirmed through content validity and Cronbach's alpha coefficient, and the results were analyzed using inferential statistics (analysis of variance and Kruskal-Wallis test). RESULTS: The results of this study showed that the barriers for midwives to achieve professional management positions in order of preference were organizational barriers (71.4%), cultural barriers (42.4%), and individual barriers (30.8%). CONCLUSIONS: Based on the findings of this research, organizational barriers are the most important obstacle to achieve professional management positions. Therefore, the role of the authorities is emphasized to eliminate organizational barriers and provide more resources to reduce this problem.

Educational Needs of Women in Relation to Postpartum Religious Orders.

INTRODUCTION: Religious orders are one of the educational needs of the postpartum period. This study was conducted to determine the educational needs of postpartum religious orders. MATERIALS AND METHODS: This cross-sectional study was conducted among 421 postpartum women and 15 specialists. Quota random sampling was conducted from January to March 2014 in Isfahan, Iran. Data analysis was performed using the Statistical Package for the Social Sciences software and statistical methods. RESULTS: From the perspective of women and specialists, the results showed that the educational needs of women in postpartum religious orders is high. CONCLUSION: Considering the high educational need in the field of postpartum religious orders, it is necessary to integrate education in prenatal and postnatal health education programs.